Increased circulating soluble intercellular adhesion molecule-1 in acute myocardial infarction: a possible predictor of reperfusion ventricular arrhythmias.

OBJECTIVES

Myocardial ischemia/reperfusion induces ventricular reperfusion arrhythmias (RAs). Significant parts of RAs are considered to be evoked by oxygen free radicals. Inasmuch as activated leukocytes release oxygen free radicals, and as the intercellular adhesion molecule-1 (ICAM-1) plays a major role in leukocyte infiltration, we examined whether there may be a relationship between plasma levels of soluble ICAM-1 (sICAM-1) and frequency of RAs in patients with acute myocardial infarction (AMI).

DESIGN

Prospective study comparing the two AMI patient groups with or without RAs.

SETTING

Coronary care unit and cardiac catheterization laboratories in a general hospital.

PATIENTS

Twenty-three AMI patients (eight women and 15 men, aged 32 to 79 yrs).

INTERVENTIONS

All patients received percutaneous balloon angioplasty with or without previous intracoronary thrombolysis. Significant RAs were defined as at least one of nonsustained ventricular tachycardia, multifocal premature ventricular contraction, and frequent premature ventricular contraction occurring >15 times/min, which were not observed before reperfusion.

MEASUREMENTS AND MAIN RESULTS

Plasma sICAM-1 levels were measured using an enzyme-linked immunosorbent assay. The plasma sICAM-1 levels at admission were significantly greater in RA(+) (243 +/- 60 ng/mL) than RA(-) group (192 +/- 44 ng/mL) (p < .05). We followed plasma sICAM-1 levels up to 3 wks, and found that sICAM-1 levels were consistently higher in the RA(+) than the RA(-) group. Simple regression analysis showed no significant relationship between plasma sICAM-1 levels and age, systolic and diastolic blood pressures, or serum creatine kinase activity. The two AMI groups showed no differences in age, gender, events of major coronary risk factors, preinfarction angina, and medication.

CONCLUSIONS

The increase in the plasma levels of sICAM-1 was observed in patients manifesting ventricular RAs. This increase in sICAM-1 levels was observed as early as at admission. The increased plasma sICAM-1 levels may be a useful biochemical marker for predicting myocardial reperfusion injury such as RAs in AMI.